Lucinda Adams, Emma L. Smith, Dev Tilakaratne, Vicki Krause
{"title":"Tuberculosis reactivation following apremilast therapy for psoriasis: Time to consider routine TB screening?","authors":"Lucinda Adams, Emma L. Smith, Dev Tilakaratne, Vicki Krause","doi":"10.1111/ajd.14364","DOIUrl":null,"url":null,"abstract":"Apremilast is a relatively new oral treatment for psoriasis, which reduces expression of pro‐inflammatory factors, including tumour necrosis factor‐α (TNFα), critical to the immune control of <jats:italic>Mycobacterium tuberculosis</jats:italic> infection. In randomised controlled trials (RCTs) for apremilast no new cases of active tuberculosis (TB) were identified, thus, screening for latent TB infection (LTBI) is not currently recommended prior to apremilast initiation. We describe a case of <jats:italic>M.tuberculosis</jats:italic> reactivation shortly after commencement of apremilast for psoriasis. We are recommending clinicians perform LTBI risk assessment in all patients, and appropriate LTBI screening in select populations prior to apremilast initiation.","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australasian Journal of Dermatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/ajd.14364","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Apremilast is a relatively new oral treatment for psoriasis, which reduces expression of pro‐inflammatory factors, including tumour necrosis factor‐α (TNFα), critical to the immune control of Mycobacterium tuberculosis infection. In randomised controlled trials (RCTs) for apremilast no new cases of active tuberculosis (TB) were identified, thus, screening for latent TB infection (LTBI) is not currently recommended prior to apremilast initiation. We describe a case of M.tuberculosis reactivation shortly after commencement of apremilast for psoriasis. We are recommending clinicians perform LTBI risk assessment in all patients, and appropriate LTBI screening in select populations prior to apremilast initiation.
期刊介绍：
Australasian Journal of Dermatology is the official journal of the Australasian College of Dermatologists and the New Zealand Dermatological Society, publishing peer-reviewed, original research articles, reviews and case reports dealing with all aspects of clinical practice and research in dermatology. Clinical presentations, medical and physical therapies and investigations, including dermatopathology and mycology, are covered. Short articles may be published under the headings ‘Signs, Syndromes and Diagnoses’, ‘Dermatopathology Presentation’, ‘Vignettes in Contact Dermatology’, ‘Surgery Corner’ or ‘Letters to the Editor’.
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